Laparoscopic transillumination for the location of anterior abdominal wall blood vessels

Objective: To determine the efficacy of transillumination for locating abdominal wall vessels prior to trocar placement during laparoscopy. Design: Prospective clinical descriptive study, Setting: Normal human volunteers in an academic research environment. Patients: Forty-seven white and 21 black women of various weights undergoing laparoscopy for clinical indications unrelated to this study. Interventions: None. Main Outcome Measures: The location and number of abdominal wall vessels visible by transillumination were recorded for each patient. Results: In women of normal weight, a single vessel could be seen approximately 5 cm from the midline in >90% of the patients, and second vessel approximately 8 cm from the midline could also be seen in 51%. The more medial vessels did not correlate with the course of the inferior epigastric vessels seen laparoscopically. The ability to see vessels was decreased significantly by the patients' weight but not by skin color. Conclusions: Superficial abdominal wall vessels may be located by transillumination in the majority of women of normal weight regardless of skin color, but is of less value in overweight and obese women. However, the deep (inferior) epigastric vessels cannot be effectively located by transillumination, and thus other techniques should be used to minimize the risk of injury to these vessels.